NICOLA C BENNETT Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****04

License Status

INACTIVE

Business

First Name

NICOLA

Middle

Last Name

BENNETT

Business Name

NICOLA C BENNETT

Original Issue Date

07/14/2016

Effective Date

03/04/2024

Expiration Date

05/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/09/2025